Unknown Individual – Podiatrist, NPI 1356495915

Unknown Individual is a healthcare provider. based in Macon, Georgia. specializing in Podiatrist. They hold a License No. POD000780 (GA). The NPI Number for Unknown Individual is 1356495915

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356495915
Phone
(478) 745-2600
Address
1854 FORSYTH ST
Deactivation Date
24 April 2024

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
4787452600
Graduation Year
1994 (32 years ago)
PAC ID
7719143064
Group Practice PAC ID
9739177106
Professional Enrollment ID
I20150413001611
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1854, Forsyth Street, Macon, Bibb County, Georgia, 31201, United States

    MACON, GA 312011169

    Phone: (478) 745-2600

    Fax: (478) 742-5399

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $88.

Total Amount is formed as General ($88) + Research ($0) + Ownership ($0) = $88.

Last reported payment date: 2023-03-09 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($88).

Total Amount

$88

General + Research + Ownership

Payments

1

Total payment records

General Amount

$88

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
DePuy Synthes Sales Inc.$88
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes2,102573$0
99204New patient office or other outpatient visit, 45-59 minutes163163$0
73630X-ray of foot, minimum of 3 views10884$0
99215Established patient office or other outpatient visit, 40-54 minutes8787$0
20600Aspiration and/or injection of fluid from small joint6736$0
View full utilization report →

Insurance plans in this area (ZIP 31201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739177106View full group profile
NameSpecialtyState
P O D I A T R YGA
P O D I A T R YGA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1356495915 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Podiatrist in the directory — Clinical services aligned with this taxonomy classification.
Where in Georgia is Unknown Individual registered?
Use Macon, Georgia as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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